Others in Attendance: Penny Asbury, April Vestal, Robert Blake, Steve Fumich, Brenda Michael, Alicia Tyler, Sonnie Strader, Judy Koehler, Georgianna Tillis, Michael Painter, Elizabeth Richmond, Chuck Conner, Ken Stone, Anna Reno, Malinda Turner, Andrew Dunlap, Jacquelynn Copenhaver, Patti Crawford, Parr Thacker, Melissa Marco, Kathryn Greenlief, Margaret Novacich, Ralph Utzman, Howard Stallard, Sandra Baker.

Chair, Dennis McCutcheon called the meeting to order at 2:40 PM.

An introduction of all in attendance was made.

A minute of silence was observed for all of those involved or who have lost their lives in the September 11th tragedies in New York and Washington. DC.  Hilda Heady continued with a prayer.

A motion was made to accept the consent calendar as written. The consent calendar was unanimously approved.  (Ferrari/Shires)

Hilda announced that Dr. Lewis was absent due to being called to work on some of the issues going on as a result of the interim legislative sessions. He is working on the medical malpractice response and the Governor's proposal to cover some physicians under the Board of Risk Management that covers higher education and our students.

Discussion on RHEP and AHEC
Dr. Nottingham stated that the program began September 1st. He reported that the dollars have not begun to flow, as of this time, due to budgets and accounts being set up. An attempt to establish a program is being made and then the development of the AHEC center being geared to be established in the eastern part of the state.

Hilda reminded everyone that the drafted Memorandum of Understanding: WVRHEP and AHEC was distributed at the July meeting for review.  Now is the time for discussion, questions and/or vote relative to the RHEP or AHEC program.  Is bullet point #7 correct in stating that the AHEC center will establish contracts or affiliation agreements with RHEP consortia established by the advisory board.  Dr. Nottingham stated that it is correct and that is how the proposal was written.   There is no standard format of contractual agreements, this is something to be developed in each region. The Vice Chancellor will appoint the council on graduate health professionals education that would be an internal group within RHEP which would be the most logical group to serve as an advisory function statewide for all of AHECs as they come up in relationship to RHEP resources in their local communities.

Jim Welshonce stated that an AHEC meeting was scheduled last month between Eastern AHEC and Mountain Health Consortium and the meeting was cancelled. Dr. Nottingham stated that the meeting will be rescheduled. An attempt to develop the program meeting the administrative organization that will set up the AHEC program at the Charleston Division will be made and at the same time, work with the community to develop the first center. The budget needs to be approved finally by the Feds., and get things in place before negotiations leading to any contractual arrangement are made. Dr. Ferrari asked what do we need to approve?  Hilda pointed out that the question before the panel for vote is as follows: "Are you ready to vote on accepting the resolution of the memorandum of understanding that outlines the different interface points between RHEP and AHEC?"  A motion was made to accept the outline of the AHEC & RHEP resolution. (Shires/Meckstroth)

Discussion on the Motion:
Regarding the budget process and Dr. Nottingham's statement that we were waiting on approval from federal level, April asked, "Was the wait for the approval of the overall budget?"  Dr. Nottingham responded that it was only for the first year budget, the Feds. wanted changes in the way we did calculations in mainly the eastern section.  Can dollars be moved around in the budget?  The Feds. can do anything they wish to the budget.  We are waiting to hear any day now that the budget has been approved. The budgets for the second and third years have already been approved.  The total amount for the first has been approved.  We are waiting on the fine tuning of the first year to be approved, i.e. line items.  Making sure Feds see that at least 75% of the total amount goes out to the first AHEC.  More money for the community and the Feds. are going to approve it.

April asked about the status of the match?  One of the items that need to be negotiated in the community and why it is best to slow down the process in community a bit until we find out the final word on the budget and talk about the cost sharing aspects, as well as request a waiver from the Feds. for 75%-25% match.

April asked whether or not the local AHEC boards would have the ability to move line items?   Yes, the only time prior approval from the Feds. is needed if 25% or more is moved.

Dennis McCutcheon questioned the meaning of the word "undergraduate" in bullet #4.  Dr. Nottingham interpreted "undergraduate" as "RHEP".  If RHEP is already organized  along with AHEC, which is federal, is this going to be the case of the "Tail wagging the dog?"  Dr. Nottingham stated that he did not think that it was at this level of intensity.  However, any time a contract or affiliation agreement that is approved for AHEC also has to be approved by the Feds. or the funding may be lost.

This memo was not written as a memorandum agreement but was written to show points that Dr. Nottingham wanted to bring forth to show where he was coming from in AHEC just in case there were any misunderstandings regarding the interaction between the two programs (RHEP and AHEC).

Hilda feels that the consortia should understand exactly what the interface will be and we will have a starting point and can begin to define relationships locally. We should decide that these are the points of agreement or send the document back for further review.

Jim Welshonce called the question and the motion passed unanimously.

Vote on Policy Revisions

Margaret Novacich reported the RHEP Finance Committee with the assistance of Doak, Cuppett and Poling created seven new fiscal policies related to the reporting and auditing of the RHEP program.  The entire DCP, Inc. report (posted on the web site) was reviewed by a large group of agency administrators and site coordinators who attended a finance committee meeting.  Margaret and the committee were instructed to draft policies to incorporate the recommendations made by DCP, Inc. These policies have gone through the approval process of the Finance Committee and are now being brought forth to the Advisory Panel for approval and action.  The policies have been posted on the web site for review by any of the partners.

Dennis McCutcheon reminded the panel that each policy has to be voted on separately.

Policy 2001-01 * Quarterly Reporting * A motion to accept this policy as posted was made and unanimously passed. (Ferrari/Shires) Jane Horst conveyed that some lead agencies might not be able to meet quarterly reporting time period. Margaret stated that the committee will make allowances for the first year and will work with the consortia for their quarterly reporting.  The committee decided to leave the 30-day deadline language in the policy for future use.

Policy 2001-02 * Annual Reporting * A motion to accept this policy as posted was made and unanimously passed. (Ferrari/Mitchell)

Policy 2001-03 * Lead Agency Audit - A motion to accept this policy as posted was made and unanimously passed. (Ferrari/Shires)

 Policy 2001-04 * Expenditure Documentation - A motion to accept this policy as posted was made and unanimously passed. (Ferrari/Mitchell)

Policy 2001-05 * Project Budget - A motion to accept this policy as posted was made and unanimously passed. (Degges/Ferrari)

Policy 2001-06 * Carryover Funds - A motion to accept this policy as posted was made and unanimously passed. (Ferrari/Nottingham)

Policy 2001-07 * Program Payments to Lead Agencies - A motion to accept this policy as posted was made and unanimously passed. (Ferrari/Mitchell)

Hilda commended the Finance committee and Margaret Novacich for their efforts put forth over the last year and a half getting these policies done and the detailed work with Doak, Cuppett and Poling, the performance audit firm, in putting these policies together and getting us to this point.

Policies 94-01, 97-02 and 98-02 are enclosed for your information.  These policies had a few word changes.

Hilda talked about Allied Health Representatives serving on the Advisory Panel.  Since our program has been broadened and involves so many disciplines is there a need to look at having other allied representation on the panel either from the academic or practice community?  There is nothing in the legislation prohibiting us from adding other membership to our own panel.  The floor is open for discussion.
 
Chuck conveyed that Allied Health Professions has been a big part of us since day one and they add strength to our partnership.

Hilda asked, "Do we want to entertain the idea of having one slot dedicated to allied health and name what those disciplines might be or one slot per allied health discipline?" Dr. Ferrari suggested that we consider having one person to represent allied health to start with, and if further representation is needed we can deal with opening up slots.  Hilda said that WVRHEP currently has rotations for 10 different disciplines of health professions and four (specified in the legislation, i.e. dentistry, medicine, nursing, and pharmacy) are already represented on the panel through their respective deans or designees.  The other disciplines are:  PT, OT, PA, Dental Hygienists, Social Work, and Clinical Psychology. The representative could be a academic person, community based person, or an allied health person.

Dennis McCutcheon suggested that this topic be taken up by one of the committees and report to the panel at another time.  Dr. Ferrari stated that the School Committee will take on the Allied Health/Complimentary Health Profession slot decision and present to the Advisory Panel at a later date.

LRC * IT (Information Technology) * April reported on the revamping of the LRC Committee. This committee is now the IT (Information Technology) Committee. This committee discussed how to address growing needs in technology within RHEP without additional funds, which are desperately needed.  There will be five subcommittees within the IT committee:  TRACKER * Chair, Mike McCarthy; Website Development; Support, which will be troubleshooting for RHEP consortia; Evaluation which is the evaluation of the IT resources and the committee's functions; Standards and Recommendations which will recommend textbooks for the LRC (Learning Resource Centers) and any information technology recommendations on hardware for the resource centers, etc.
 
The first meeting will be held in October to develop work plans and the sub-committees. Parr Thacker and April Vestal will be the interim co-chairs of the IT Committee.  The person replacing Mark Allen will be the Chair of the IT Committee.  If you have someone in the consortia to serve on sub committees, please let April know by e-mail. Most meetings will take place via e-mail or conference calls.  If any questions, suggestions or comments contact April.

Finance Sub-Committee
Chuck Conner reported that the committee has been looking at the fact that RHEP received no additional funding; therefore the committee has been looking at ways to utilize our money in the best ways possible. With the help of Doak, Cuppett and Poling, data was put together regarding base administrative costs that are common to all of the sites.  Other data was gathered from sites, lead agencies and site coordinators regarding their costs: housing costs, costs of operations, salaries, etc.  Looking to fund priorities, the sub-committee is looking at three issues:
1. Field Faculty/Preceptors' costs
2. Housing Costs
3. Administrative Support

There are extremes in consortia.  The consortia are working together to see how methods in one consortium may apply at other consortia.  Also, the committee is looking at who has greater needs.  Hilda is developing a letter of philosophy of direction and sending it to those faculty and preceptors who are receiving some sort of funding to let them know the direction in which we are headed.  The committee will continue working on a solution to our needs.

Community/Student Panel Committees
Billie Hall reported that they talked about the joint retreat they had January 2001. She conveyed that they had a good retreat and went over some of the points that were brought forth at that retreat * "Where do we go from here? What can we implement? What do we need to further discuss?"   Looking at having another retreat tentatively in March 2002 and also having another joint meeting in November of 2001 to plan the retreat.

Faculty Development Day
Sandy reports that there were 113 registered.  This included presenters, support staff, site coordinators, etc.  April reported that overall; the conference was a success despite having the last portion of our conference, sponsored by the Mountain State Geriatric Education Center, cancelled. Our conference ended on Saturday instead of Sunday as planned because those presenting from Mt. Sinai in New York were unable to attend.  Those attending enjoyed the content of the conference and the networking opportunities.  The Faculty Development Committee was pleased with the outcome.
.
Jill Cochran would like to have a report generated of those attending stating their discipline and their consortium or school. Lots of networking went on and a candlelight service was held on Friday night remembering the September 11th tragedy.

School Committee
Norman Ferrari reported that the School Committee has been trying to finalize a statewide recommendation for needlestick, sharps policy.  He stated that the schools have their own individual policy, if a student would get stuck with a sharp object or exposed to infectious body fluids at an RHEP site. This was not finalized due to the absence of the Vice Chancellor. The Vice Chancellor is involved and is working on assistance of funding.  This project is very close to finalization.

Executive Director's Report
Hilda said that she was still getting considerable feedback from the New York Times article.  The New Physician magazine has contacted Hilda about running a story. She has also been invited to be a guest author to do a small piece in JAMA, which will be published in January. They wanted her to talk about general rural health policy health issues and the differences between urban and rural health. The National Public Radio has expressed interest in our program. Hilda has a proposal to do a special on the WVRHEP programs with the National Public Radio and a National TV magazine program. They want us to pay them a retainer fee of $4,000 per month for a three month time period to get at least one other national exposure kind of piece.  If the panel thinks it is worth it, Hilda would try to get some private funding as state fund cannot be used.  A discussion was held.  This is the third year running that we have had a half a million-dollar request for community support money and publicity might help with public awareness.  Hilda is asking for feedback and information from the panel in terms of handling this.

Jane Horst stated that all feedback from the snowballing effect of The New York Times article has all been positive. Due to this article, Hilda will be giving the opening speech at a statewide Summit on Healthcare Workforce strategies sponsored by the Oregon AHECs.

Jim Welshonce suggested we check on state dollars to enrich the state (tourism dollars). State dollars cannot be used  to fund this venture. If there is a way to fund this, go with it.  Do we want people paid to promote us? A public relations consulting group based in New York has looked at the research that was done on us last year. Bill Shires' suggested approaching PR firm that the state uses.

CCPH board will have a board retreat September 28th.  Hilda conveyed that invitations will be going out for the reception and dinner. If you are interested in attending the reception it will be held at 5:30 PM and dinner at 6:30 PM at the Embassy Suites.  Legislators have been invited to attend for a policy discussion with the CCPH board members on their support of the RHEP program.  The reason for coming to West Virginia is that we are the largest community campus based partnership in the country, having the greatest amount of state funding along with a piece of legislation that created us.  This board is interested in learning more about that from the legislative policy angle. Legislators have been invited to talk with the board.  It would be of great benefit to confer with own legislators in attendance.

Hilda is continuing to develop the proposal with input from others regarding of our tenth year recognition and possibility of an invitation conference next year. Working on setting up meetings with the Secretary of Education and the Arts to see what it would take to be called a Governor's Conference and to invite people particularly from the region to attend.  Right now the proposal calls for evaluation dollars, a long term view of RHEP experiences, to come up with a series of publications and/or a book, to look a having a conference in 2002 which would be our tenth anniversary, in 2004 a midterm assessment of long term evaluation and in 2006 which will be the tenth year anniversary of the implementation of required rural rotations.  If we can get enough private foundation groups interested, we could really contribute nationally to the knowledge base in partnerships as a tool for recruitment and retention.

Those who have copies of original RHI legislation, it is important for you to go back and look at that again relative to the call that was put in there for residency and graduate health professions training and education.  It is proven that, particularly in medicine, that where an individual does their residency training, is the greatest indicator of where they will in fact practice.  Most research shows that they will establish a practice within 75 mile of where they completed their residency training.  Our objective is to try to get residency training in some of our more rural areas throughout the state.  The AHEC program gives us the opportunity to look for a way to take some federal dollars and our state resources to meet this objective.  Medical residency training, graduate nurse practitioner training and PharmD training at the community level would greatly enhance our recruitment and retention strategies and the AHEC grant can do this.

Meeting adjourned. (Ferrari/Welshonce)